2.1 Ageing and the Body Flashcards
What does ageing impact?
- How well the body copes with new and ongoing insults
- How we treat and manage patients
- Ongoing care- becomes more challenging
Why is it important to consider the impact of ageing?
Over 50% of older people have at least 2 chronic conditions
WIll be treating older people in all branches of medicine (except paeds)
How does the skin change as we age?
- Elastic tissue becomes less effective
- Skin becomes less tight
- Becomes thinner and more susceptible to damage ergo more fragile
What problems happen as the skin ages?
Bruises easily
Difficult to get IV access
Skin tears
Ulcerates easily
How does reduced elasticity effect the lungs?
- Decreased compliance
- Decreased passive exhalation
- Also important in holding open terminal airways and alveoli
- Results in weakened/ineffective cough, stasis of mucus leading to infection
What values decrease which are used to measure lung health in ageing patients?
Total lung capacity
Forced vital capacity
Forced expiratory volume
What external factors can cause premature degeneration of the elastic tissue in the lungs?
- Work exposure- asbestos
- Smoke exposure
- Repeated infections
- Chemical/toxin exposure- fibrosis causing, e.g. amiodarone
What does reduced lung function put you at a greater risk of?
More likely to
-Be acutely unwell
-Need hospitalisation
-Need oxygen/ IV antibiotics
What post-operative respiratory complication are more likely in elderly patients?
Atelectasis
Pneumonia
Pulmonary embolism
What type of drugs are more likely to cause respiratory problems?
Sedating drugs
How is the CVS affected by ageing?
Blood vessels become more stiff as we age, particularly arteries (Ca2+ deposition + elastic tissue degeneration)
Elastic recoil is reduced, less expansile arteries
-Increased resistance to blood flow
-Hypertension
-Increased cardiovascular work
-Increased riskof LVH
-Decreased left ventricular volume
-Heart failure, left initially then right
What are the risks of uncontrolled hypertension?
Stroke
MI
CKD
HF
AF leading to stroke
Vascular disease e.g. AAA
Vascular dementia
Vision
How does hypertension lead to atrial fibrillation?
- Increased stretch of the atria
- Atrial stretch causes small areas of damage
- New foci of electrical activity
- APs generated by new foci
What happens to the renal system as we age?
GFR decreases, roughly decreases by 1ml/min/m2 from 30-40
What causes GFR to decrease as we age?
Structural changes
Atheromatous vascular disease
Reduced CO